Provider Demographics
NPI:1851307326
Name:HOSPICE OF THE RAPIDAN, INC.
Entity Type:Organization
Organization Name:HOSPICE OF THE RAPIDAN, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:KATHY
Authorized Official - Middle Name:R
Authorized Official - Last Name:CLEMENTS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:540-825-4840
Mailing Address - Street 1:PO BOX 1715
Mailing Address - Street 2:
Mailing Address - City:CULPEPER
Mailing Address - State:VA
Mailing Address - Zip Code:22701
Mailing Address - Country:US
Mailing Address - Phone:540-825-4840
Mailing Address - Fax:540-825-7752
Practice Address - Street 1:1200 SUNSET LN
Practice Address - Street 2:SUITE 2320
Practice Address - City:CULPEPER
Practice Address - State:VA
Practice Address - Zip Code:22701
Practice Address - Country:US
Practice Address - Phone:540-825-4840
Practice Address - Fax:540-825-7752
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-01
Last Update Date:2014-10-16
Deactivation Date:2014-10-09
Deactivation Code:
Reactivation Date:2014-10-16
Provider Licenses
StateLicense IDTaxonomies
VAHSP-0640251G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251G00000XAgenciesHospice Care, Community Based
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA00013230001OtherUNITED HEALTH INS
VA142293OtherSOUTHERN HEALTH INS
VA337445OtherANTHEM INSURANCE
VA004915054Medicaid
VA337445OtherANTHEM INSURANCE